How will RI spend its $58 million dollar grant?

First, a clarification- Lt. Governor Roberts says Rhode Island didn’t receive level two funding for its health insurance exchange just because as I said on Tuesday it was the first to turn in its paperwork.

We’re the first state to be ready. The way that we have a collaborative effort, both inside government and through the health care reform commission with outside government people involved in health care – consumers, health insurance. We are ahead of most of the country, which is why you saw us be the very first state to receive this funding.

But even Elizabeth Roberts was surprised Rhode Island was the only state to receive the multi-year grant.

I was very confident in our application, but I was really proud that we actually led the country in this effort. I was expecting that there would be others with us. There are moments when we should pause and reflect on the fact that we can do something very well and in health care we have a record of doing things very well.

So now that we’ve received the money, how will RI spend it? If you want to really dig into the state’s game plan, check out the 34 page narrative it sent to the federal government. If you want a shorter read, here’s the one page summary. Or you could read my bullet points.

The state says the money will go to seven different projects-

1. Technical Infrastructure

Remember, the health insurance exchange is at its most basic level a website for buying health insurance. Rhode Island must design the website, figure out how to check and calculate who’s eligible for subsidies, think about special features for small businesses and create a system that keeps Rhode Islander’s personal information secure.

2. Consumer Support

For the folks that aren’t tech savvy, or just want to talk to a person, Rhode Island needs to offer more than just a website- someone to answer the phone and walk Rhode Islanders through the process of buying health insurance or even an office where residents can walk in for help.

3. Reporting and Evaluation

Rhode Island has to report back to the Federal Government about how the health exchange is working, but it also wants to gather data for its own purposes- who’s using the exchange and how can we make it better? Rhode Island needs to create more technical infrastructure to gather that information.

4. Governance and Staffing

The state has to figure out how to structure the management team for the exchange and then hire some people to do the day to day work of keeping the program running.

5. Health Plan Certification and Qualification

So, the federal government is creating rules about the kind of services a health plan has to offer if it wants to sell insurance on the exchange. That way consumers don’t have to worry about buying some sort of sham insurance that has a $20,000 deductible and doesn’t cover obvious things like hospital visits or cancer treatments. Rhode Island has the option of creating even stricter rules. It also must design a way to evaluate whether health plans meet those guidelines.

6. Financial Sustainability

Rhode Island might have an extra $58 million dollars right now, but by the beginning of 2015, the health insurance exchange has to pay for itself, without any help from the federal government. RI has to figure out a way to generate income.

7. Oversight and Financial Integrity

The state has to develop a way to keep an eye on the exchange, making sure it’s running the way it should.

No word yet on the actual dollar break down of these projects. I’ll keep asking.